Role of Transcranial Magnetic Stimulation in Cognitive Disorders and Late Life Depression

Depression and cognitive impairment in late life are significant public health problems. Treatment of depression in late life can be challenging due to potential adverse effects related to pharmacotherapy. Depression in late life is one of the most important risk factors for the development of cognitive impairment and subsequent dementia. There have been some recent developments in treatment of cognitive impairment due to Alzheimer's disease, however these treatments have several potential adverse effects and are not easily accessible. Thus, there is a need to develop novel treatments for both late life depression and cognitive disorders in late life. Brain Stimulation interventions such as Transcranial Magnetic Stimulation (TMS) have shown promise in treating late life depression. TMS has also shown efficacy in enhancing cognition, however the results have not been uniformly replicated. TMS in combination with electroencephalography can also help improve understanding of neurophysiological mechanisms underlying cognitive impairment. Thus, while TMS is approved for treatment of depression, its role in treatment of cognitive impairment, and impact of TMS on neurophysiological parameters is less clear. Further, effects of treating cognition using TMS on caregivers of those with cognitive disorders are even less well understood. In this session, we will review use of TMS for treatment of late life depression, and cognitive disorders. Original data will be presented on a novel TMS paradigm using deep transcranial magnetic stimulation (dTMS) for treatment of late life depression. Further, we will present data on use of TMS for understanding mechanisms underlying cognitive impairment, its role in improving cognition, and its impact on caregiver burden.